Gastric Stimulation for the Symptoms of Gastroparesis
Gastroparesis is a condition in which the stomach takes too long to empty its contents. Food and liquid stay in the stomach for a long time, which can lead to symptoms such as nausea, vomiting and abdominal pain.
Most children with symptoms of gastroparesis respond well to dietary changes and medication. But if those therapies are not enough, your child’s doctor may recommend a gastric stimulator. Cincinnati Children’s is one of only a few pediatric institutions in the country to offer this therapy. It is available through our multidisciplinary motility clinic, whose pediatric gastroenterologists and pediatric surgeons have special expertise in this type of therapy.
A gastric stimulator is a small device that is like a pacemaker for the stomach. It is implanted in the abdomen and delivers mild electrical impulses that stimulate the stomach. This allows food to move through the stomach more normally, relieving the symptoms of gastroparesis.
A two-phase procedure
The gastric stimulator is a flat device that is about two inches high and two inches wide. Before implanting it, the gastroenterologist conducts a “test phase” to determine whether the therapy is likely to be effective. This begins with an outpatient procedure. The surgeon guides a wire through the child’s nose into the stomach, and attaches the end of the wire to the inside of the stomach via an upper endoscopy. The end of the wire that remains outside of the body is attached to the gastric stimulator. For the next two to three weeks, your child will wear the stimulator on a cord that is placed around his or her neck.
During the test phase, you and your child will keep track of his or her symptoms and compare them to past symptoms. If the stimulator is having a positive effect, the surgeon will implant the device for longer-term therapy. If not, the wire will be removed.
The surgery to implant the stimulator is minimally invasive and done on an outpatient basis. It involves inserting the device into the abdomen and attaching electrodes to the outside of the stomach.
Gastric stimulation is effective in about 90 percent of children who “pass” the test phase and have the device implanted surgically.
Life with a gastric stimulator
Our team will provide your family with the education and support you need to make the most of this therapy.
A gastric stimulator does not make any noise, and it is not visible to others. Your child will be able to feel it through the skin. You and your child will not need to “operate” it, although you can adjust the strength of the electrical pulses using a remote control device.
Your child will return to the Cincinnati Children’s pediatric multidisciplinary motility clinic for follow-up care. When the battery power becomes low (usually within four to seven years), the surgeon will remove the device and replace it with a new one.
Children with gastroparesis who use a gastric stimulator usually experience substantial improvement in their symptoms. For some children, the therapy may be discontinued after a period of time because it is no longer needed. For others, however, the stimulator is needed long term.
Many patients continue taking medications or need other therapies while using the gastric stimulator. At Cincinnati Children’s, our multidisciplinary care team is committed to finding the combination of therapies that helps your child live a normal life, as free as possible from the symptoms of gastroparesis.
